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15350 SW SEQUOIA PARKWAY STE 100 i I lie Ci F A 3 ` `��r_> (►l I' i/}�� /�'� A, PrJ 65. A At G OF Trawn Ved ......ApPrONM• r ICpnctlOnall)� ApprOV00 •...��.. its: far only 1;�n VI :;!'. 4 - ,..,.� _ .. Att SChSee letteT W- , Job l fat@: .�/!. ! C / 1 WYATT FIRE PROTECTION INC. __ �� I 1 �\ 1``f .� �Y � � ` �'.J LF �.4 , \.� �►� ) t 04 '1. 4045 LLWTIO�N DMAINIENANCF 15350 SW Sequoia Pkwy ' �' • TItiAHQ OREGON 87223 Suite 100 1 Of 1 TOTAL 5PPINKLERS DATE THIS SHEET ^' HANGEP ! GENJU DEVICES - STANDARD ..- - SYMBCXS $TAfVDARp SYMBC)l5 A/PROVALS R INxPE CONTRAC HOOKS LE TN AS DM*NAT® SMINKIHts - -----____- _-. - -. ___�_ __ _- --_---.— `� I IKII R NEAT) SYMBOL S — CT►ON PHOW COWRACT WITH T CAIS >R S FIG ►1-! CHUNG FIG. ROD i Rjwj � TYrE OK a CITY + "T INDICAroo vAtvE ,', AIAAM I'NECK VALVE � . ... t/PRIGi;T O+v tit Ot1TIET t` __.�.__�_._ rCD fp ISS CFI0NG Flt,. ROD A RIW, `Nf r �/�1 rti �) f( r rfY VALVE a RISER w;'A1A1lM VALVE t -,. 1'1941" ENT ON 1/r OUTLET ___._.._. ' - . _ --- '� - ..�.._.____ .. ENGINEER SHEET -i 0 A -- OOACN SCRt1N, ROO i RING _. � .__ ... ► nftf HYDRANT RIS" w (�► UPRIGHT ON '" $Wbg Up A # e COWL NSfN; ROq i RING 0 __.. CIT1� - _ASE ROO R RING « .___. _ �._ . LIRE DEPT ' lOWWTI - Tr-N r1RO fit 0 E,XIMfS,nN r- I ON RISER w/ETiC SW y >'f�NUENi ON t" P � � n 14 10 - EYE ROT) 3 PING �. __._ _ ._♦ _ Z O 3 t Y A i _ ._ F I USk SPR CON I" LoRhP vV A rt* UlrT. GAT* VALVE RISER w/DEl t1'3E SALVE RW t RING _.� .._,__ �_.___ .... _. _. ARC1M'T'�T _ _ u __. I SMNG 0 a VALVE l 1�i - ATTR MO" Rtl.l `- - __. _ _ (✓ k Ir:►,�1 i t 'C'GtrAnar, .,� �. - � r w � oftr PtwDENT ON 1� !)ROd _. __ .__.__... _-- e�N�t �.- ��.YM t c r''!` ` ,t: 11 - 'r ROD AW.A E Cil ROD ` P,N(, _.. _. _ ! �, AaoR+slalft -- — ___ .._ ______._. .._... �+..a NEW UNOERi'iR "4D " --r StDtWAlI ON 1 /2" OUTLET -«..r-__._._.-_ ._..w....�_.._. iC. �Irr ANQ/t ,RGN �;,P Rr � A WIN(, �. a, CITY 1 �7 (.J y 4.ti) �� ,ar'I I A at T - UP d DN AT SAME lOCATK)N CITY ■...� ►• •+� fxtSl VNDERCs!POUNt� ,,�,�,•" hri - ftt151� FIRE D£TrT. C!C)IW�. !•I*, ..._..»........„,.,..-.....y.4.,_._._._..__�..--•-__.....,__.. :.,._^.__ ,,, _._. -+w�r�w.e.annw+wr.eMr�a..... wr,...avoe.ww.ren+d.��.c,:-„ :e.<�.�rrY..,,....:,., __. __. . 4..,..r..warrr�swr ay .,��.Mn., .am�en_ ...Y..� .. .. �,....w. .. .,...,_. ._- ..._......nr. .. i - ,Rw,+...,,,, .__ _ ,. :r �MIEiCrMIQ�a r"'yxM'y►� IF THIS NOTICE APPEARS CLEARER THAN THE DOCUMENT, THE DOCUMENT IS OF MARGINAL QUALITY. T �99 m l IT I_, VED I ' IJljljlljl ; ll � I ) ! ! ) I ! { ; I ! � ilil � l ! I � 1 ! li � ; i i i ! . ! ' ! ! ` I ': ! ! iii i i i Ii � il ) II I ! ! lI � : II it II ! i i i �•II� I� � It , ) Ir lil IiI 111 j � Ill ilk CI IIIIIi � I : . INCH I MAd IlM CHINA41 ( I ` 'ti' 1 --gym T 3 - � 5 1 1 8 1 I 1 1 1 I 1� 14 15 1i 1117 1b 1! TA 1 t 4 i 11 21 t R i illlil!II!lilill!!1!'11ill!i!!iillli1il11)lIi11lIIliiillllliliiii i 11!11 i iiii iilil 11'{111 i'Iiiiii fi”"II ' { " 'li' r"' " ' i" 111,1 I; III I Ir tt ' :'t' ' tt,t Itlltt( }tIItII III tl I lilt „11,1 ,t , „Il,ti, 11 1 , , „ „ f�,,.,, r,.,,,,r,,, ,1,,,,,!,�l,,,,!,,,ril,,,,.I,rl,,.,lI,II...,.!!1. sl;lilli,�!s4s.,!I!ss!!!I!IIII !! !!I �IlI; !t„�I,l,{II.IIIltllllli)111I1lIl,Ilt„Illllli,tl„111111i1�llll��,!! ,lIItII11111tttlllllll,r�,lll{!,►,„tr.!!„a M t d f • e7 d�, r A { r' �5vlo?or, BUILDING PERMIT . . . . . . . : BUP95- P ER M I T # 0441 CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 12/05/95 13125 SW Hall Blvd.Tigard,Or*gon 97223e8199 (503)839-4171 PARCEL: 2G112DA-00400 SITE ADDRESS. 15350 SW SEQUOIA P'KWY #5. 1.00 ZON I NG i I--P SUBDIVISION. . . . : BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . 11 RE I SSUE: FLOOR EXTERIOR WALL CONSTRUCTION- CLASS OF' WORK. sALT FIRST. . . . : 0 5f N: St Ell W1 ii TYPE OF USE. --COM SECOND. . . : 2500 s F PROTECT OPEN INGril- TYPE OF CONST. .-3-11-414 . . . : 0 sf N: S. Ell W. OCCUPANCY GRP. ;A3 TOTAL------: 2500 sf ROOF CONST: FIRE RET? : OCCUPANCY LOAD: 6 BPSEMENI. -. 0 S AREA SEP. RACED: STOR. : 2 [IT. 0 ft GARAGE. . . 0 sf OCCU SEP. RATED: BSMT?:N ME-.ZZ? .-N READ GETPACKS------------ FLOOR LOAD. . . . : 50 ps f L.EFT- 0 ft RGHT.- 0 ft FIR SPKI-:Y SMOK DET. . : DWELLING UNITS: 0 FRN,r: o ft REAR: 0 ft FIR ALRM.-Y HNDICP' ACC-Y BEDRMS: 0 BATHS: 0 IMP, SURFACE: 0 PRO CORR:Y PARKING: 0 VALUE. $ - 400 Remarks : Fire si.ippress ion system. Owner. FEES BAGEL BASKET IV, INC. type amot.int by flat P recpt 5335 SW MEADOWS RD, #36!=; FIRE $ 10. 00 B 10/20/95 95--�.'71873 PRIAT $ 25. 00 Y-1 10/20/95 95-271B735 I-AKE OSWEGO OR 97035 5PC T $ 1. 25 B 10/20/95 95-271873 Phone #: 624-1333 Contractoril WYATT FIRE PROTECTION INC. 9095 S. W. BURNHAM TIGARD OR 97233 Phone #: 684--2928 $ 3,6. 2", 10TAL Reg #. . : 64077 REQUIRED INSPECTIONS ------- This pprott is issued subject to the regulations contained in the Sktsn Ceilng Insp Tioard Municioal Code, State of Dre. Specialty Codes and all other Sprinkler Final applicable laws. All work will be done in accordance with Misc. Insper-tion aporayed plans. This peroit will expire if work is not started Final Inspection within IN days of issuance, or if work is suspended for sort than IN days. V,P r m i t t e e Si at _trw; na ----------- Call for inspection 639- 4175 rtC'� PLANCK# A APPLICATION FOR PERMIT TO INSTALI, FIRE SPRINKLER SYSTEM � BUILDING DIVISION, CITY OF TIGAR.D 639-4171 w Date: PERMIT M Amt. Paid: Valuation: '40Permit Fee: U S' 5% State Tax: 1'Z5 Balance Due: `A 40% FLd: — 10 Plans must be submitted to the Building Division before installation. Three sets of the plot plan, showing the layout and the location of the nearest hydrant is required. New Installation: Addition: Repair:_ Alteration: Complete: Partial: Exitway: Basement: Hood & Vent:��_ Spray Booth: IN E`CISTING BUILDING:_— IN NEW BUILDING: NUMBER & STREET: 153S-0 S. t�J , 5 EGA ll�C� 1 A• ICUJY NAME OF BUILDING or BUSINESS: 1•� 1=-L- �3f'� ��=1 NO. OF STORIES:_ _SIZE OF BUILDING:—OCCUPIED AS: TYPE OF SYSTEMS: Wet:- AK_- Dry: Combination: STANDPIPES: OCC.HAZARD: Light ORD.GRP.HAZARD I—2`3-4 Extra DENSITY GPM/F't2 DESIGN AREA ft2 SPRINKLER AREA ft2 f SPRINKLER ORIFICE SIZE: 12.- "K' FACTOR 5•I�_ TEMP. RATING��S` OWNER: ADDRESS: CONTRACTOR:� WY/--TT" �l('► P��T�CTl(,� (� , _ f PLANS DRAWN BY: <AW E ADDRESS: �U`�5 l� 6up-tj HN� 1 — — s REMARKS: _ 4 ' APPROVED permits includes only work described above and/or on plans and specification bearing the same permit number and will comply with all applicable codes and ordinances of the City of Tigard. x _ 1 SPRINKLER COMPANY: W YAM- T HONE: b_4 - 2-9 7- SIGNATURE OF APPLICANT: BIJILDING DIVISION: a PERMIT VALID FOR 180 DAYS nerd\eomdev\Nreperm -Ak Oak Page No. 1 CASE HISTORY FOR CANE NO.; HUP95-0441 BAGEL HACKFr TV, INC. �I 15150 SW SEQUOIA PKWY ]hilt: lou 04/22/90 p Action Description R,+q/ schd/ End/ Act i,xi Notes Dimp By Update Upd Codesomt Done Done Date By _- ________-- MA HUPC007 Application received / / / / 10/19/95 PEND S 10/20/95 J BUPC009 Permit created / / / / 10/20/95 PEND B 10/20/95 B B111)C015 Plann routed to Plans Rxaminer / / / / 10/20/95 PEND B 1.0/20/95 B BUPCO24 Plans Approved/Routed to DSTs / / / / 11/26/9'. APPP JHF 11/29/95 JHF BUPC090 (P) Ready to issue / / / / 12/05/95 PASS B 12/05/95 B BIJPC100 (P) Insue permit / / / / 12/05/95 PASS B 12/05/95 B RUPC799 Pinal Inspection / / / / 09/25/95 PASS TLP 01/11/96 TLF BUPC960 Came Finaled / / / / 09/25/95 PASS TLP 01/11/96 TLP �i f 6 t 1 �j 4' p. POW W-"vmt11M r.i .pv+-..we,.w+r.,....... �' _......+w..,,....,w...,..w. »•_». .......+..wrr.....wwl•.. C11YOF TIGARD CERTIFICATE OF COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY RM I'Y #. . . . . . . I BUP95-0416 13126 8W Hall Blvd.Tigard,Orogon 97223.6199 (60.7)639-4171 DATE I SSUED t 10/31/95 t t=tRC.!~L a 2S 1 12DA-004fl10 SITE ADDRESI*11. . . 9 15350 SW 3EQUU I A PKWY #100 j, SUBA I V I S I ON. . . . i X ON I NG i 1-P l Hl_QCK-Y_�_.w± _-....I_.._._......_.._.__.LOT i....___.__________.._w.._..__.�___.____W__._.___.__. CLACS OF WORK. iALT TYPE OF USE. . . a COM OCCUPANCY GRP. i 611 OCCUPANCY LOADS -� I TENANT NAML. . . i BA17F_L BAWET Remarkel Tenmy)t modification I Own er: PFWLL BASKET 15350 GW SeOUO 1 A PKWY 44100 TIGARD OR 97224 hon�a ttt CYPRESS VENTURES, INC. 5335 SW MEADOWS RD. , #365 AHF OOWEGO OR 9703,5 � 11hane, #: E24-1333 Reg #. . a 77075 i This Certif-icate gr•aants or_°cupency of the Above referertr_ed bui .ldinq or portion thereof and confirms thAt the building has been inspected for compliance with the State of` Orgon S)pec,ialty Codes for the group, oc'c:upaancy, � nd .(se under whirl .Tie reference ermit was i sgued. , RRL) YNtd INS4�C .tt?R_.. _ ...._.._.__......_._._...__. _ kUIi� I n tlFF'TCIAL POST IN CONSP I CUOUGx PLACE I i i i i aa�� s; F ,r Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Permit # vs-- Q4vl _ r Phone (503) 639-4171 Date Issued /0 91S — FAX OF TIGARD TDD No. (503) 6$4.2772 FAX (503) 684-7297 Issued by 4'2,g -hs- <e- Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Schedule Below: Name of DevelopmentNumber of Inspection@ per posnnit allcr redl Address '1 350 Z- U-) Ser,,.includt+d: looms Q,031(00) Sum City/State2ipl— \C eb . o r-- 1-1-7035 4s. Rsridential-per unit 4 +000 firi h Cir boa t+ —_ Nalne (or name of business) — L fy ' E'er'°dd0bii1500°p It.°f pwdart r.ar Commercial❑ Residential❑ UnAW E'taW $2500 Each loilana/'d slot or AAoduiar 7 Dwm,rnq Unci s or Poo cr r S"no _- 2:a. Contractor installation only: 4b.Services or Feeders �rstaYtalNtn,allonsban,Br relederun 0V Electrical Contractof �^gi 6 T��Ar, trap aoo.mo.°tIN& � $soon �d -�— 2 Address 10 9 2 8 Ili WDKT r 201 amps in 400 amps $a,oo Ci P ORT AN tate Zi 2�� 401 `rnp'to 300 amps $12000 2 city H p _ Mot amps to 1000 amps 111180.00 2 Phone No. 255-9822 a.r,000 ttrnpe or Voss $340.00 Can tractor's license No. 2 6—3 3 C Qamnot"or«y woo _ Contractor's Board Reg. No. 4c.Temporary services or Feeders r Installation,altsrrron,or roh muion 2 Signature of Supr. Elec'n 200 arrow or'am no 00 2 I 201 anima to 400 ane !T9 00 Ucense No. 1_i � Ph ne No. 255-9821 -- — 401 snrpo ro Mo env. $10000 Over 800 aanpa to,opo vats 2b. For owner Installations: .rW■hw- 4d.Branch Circuits Print Owner's Name Now a»arslian or oaaanainn per pw* Address e)The too for Irarich ormKo iM1h City State Zp__ wo/It�or boodw rut± $500 �� a Phone No. b)Ti.a t.+lar branch c+rwits wtlrorrt The installation is being made on property i own which is pumhaaa or stmt"or weer b.. 2 not intended for sale, lease or rent. Fret branch Circuit $3500bm addeional brand+arta," Owners Signature_ 4a.Mlecaitaneous (Sarvico 0r feeder not included) 2 3. Plan Review section (if required): ea.-P Pump or nriergbn arra �— $40 00 EAdt sign or euchre liQMrnp $40,00 _ Signal c'ieur.(ra)or a lin ted onorpy --- Plasse check appropriate darn and enter fee in section 58. parnl alumna"or aauru,on $40 00 _ 4 of more nriidelfial units in one stri uR Morar WOW,(10) $10000 _ Servkx and fsedw 225 amps or morel System over 600 volts naminal 4f. Each additional inspection over Classified area or structu.,3 oxontaining special 0cajimncy the allowable in any of the above as deacAbad in NX.C. Chapter 5 Par"'rrAld'nn $3500 Pon her $3100 '-- ��-- Submit 2 sets of plana pfk with spation where any of the above In P'ettl Mao apply. Not required for temporary con@tructlon services. g. Fees: �od Sa Enter total 0}above fees $ NOTICE 5s. Surcharge(05 X total flies) $ PERMITS BECOME VOID IF WORK OR CONSTRUCT10N stubtotel S AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b.Enter 25%of line A for CONSTRUCTION OR WORK 15 SUSPENDED OR ABANDONED FOR Alan Review if required(Sec 3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS subtotal g MMMENCED. El Trust Account,r 5 1 Balance Due IWJ`P .y�, ...�., �Yr.1;,.... �,.,.,,�«„n,w.�.w�„�,.,`..,�,., ♦qMµ•: ..._ .r,,. .. ,:.+r,...,,..�,.„�.. .sre,, wMa t..�arf��,-+,v, ,wr.y�gvrw✓�, L' 1 Page No. ] CADB H787'01Y FOR CABS NO HLC95 0191 OJMRRCIAL ELECTRICAL CORP. 15-50 DW SRQUOU PKWY lhiit: 100 04/77/9• k Action Description Req/ 8c1ni/ Rnd/ Action Noten Diep By Update UPd Code Swit DMIO Done Date By -------- -------- - '- — ------ ---- -._ S BLCCOOI Applicatiai received / / / / 10/15/95 RXCD cis 11/30/95 TMP {. EXCO03 Permit created / / / / 10/75/95 RBfM CJS 11/30/95 TMP 21,MSOO M blue permit / / / / 10/75/95 PABB CJB 11/30/95 TMp IIWCMOO Came Pinaled / / / / 07/31/95 MJR 07/06/96 JF k Y- �i k 1 1 p :.r (. � � _{�. .x 's T•t y-.« N. av ,nFa.r Y ' ',"gni «,.,�..�i a ..,. ., ,,,. '+1" `1„1•F►'y^• .,,� ..qA,.,..w,-.,y .*.. ... •r,.. t I rl CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13126 SW Hall Blvd.Tigard,Oropon 97223.6199 (503)639.4171 PLUMPING PERMIT AMM P'E•RM I T #. . . . . . . : PLM95-1287 639-4.171 DATE ISSUED: 10/19/95 PARCEL: 2 S112DA--00400 +wRa SITE ADDRESS—. : 15350 SW SEQUOIA PKWY #S. 100 SUBDIVISION. . • . ZONING: I-P BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : CLASS OF WORK. . :ALT GARBAGE DISROSAI._S. . : MOBILE HOME SPACES. : TYPE OF USE. . . . :COM WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : OCCUPANCY GRP. . :B2 FLOOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . . STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . : CATCH BANNS. . . . . . . : FIXTURES---_--_-_------- LAUNDRY TRAYS. . . . . . : SF• RAIN DRAINS. . . . . : SINKS. . . . . . . . . . : 1 URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . . LAVATORIES. . . . . : OTHER FIXTURES. . . . . : TUB/SHOWFRS. . . . : SEWER L I NF (ft ) . . . . : WATER CLOSETS. . : WATER LINE (ft ) . . . . : DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . : Remat-ks : Tenant modific=ation. " Owner: ---_-._..__------•----_____._---------------______________.___ FEES BAGEL BASKET type amol.lnt by date recpt 15350 SW SEQUOIA PKWY #100 PRMT t 25. 00 B 10/19/95 95-271869 5PCT $ 1. j 11 B 10/1.9/95 95'-2711369 TIGARD OR 972 .4 Phone #: Contract or.: ---- -------------------------- GEORGE MORL.AN PI_IJMB I NG & APL I ANCES 12585 SW PACIFIC HWY **ALSO SEE -- GEORGE MORLAN PLUMBING r. TIGARD OR 97 :23 ___.________._._-_----•--_--_______.____.___ Phone #: 624-6895 t ._6. 25 TOTAL Rey #. . : 0027.:34 ------- REQUIRED INSPECTIONS ------- This pewit is issued subject to the regulations contained in the Final Inspection Tigard Municipal Crde, State of Ore. Specialty Codes and all other applicable laws. All Mork will be done in accordance with approved plans. This pereit will expire if work is not started ___�J __,•_____,__ ��_____ �._ ___ within 188 days of issuance, or if work is suspended for yore than 180 days, Permittee S i i a t m-p : I s s i1 e d B y = Call for inspu,c on - 639--4175 City of Tigard PLUMBING PERMIT APPLICATQ Planck/Rec. # 13125 SW Hall Blvd. Permit # h �4? Tigard, OR 97223 ' (503) 839-4171 1 �, MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE C New SInaj2 Family Residences Ont a 0 1 BATH HOUSE $140.00 0 2 BATH HOUSE$195.00 1 ,Job � 0 3 BATH HOUSE$225.00 � Addt>3es ar Fee Includes all plumbing fbrhrres in the dwr"'ng and the 11rat 100 feet of water service, sanitary tower and storm:w_lox. See ha below. ".�, .. ...�er....m FIXTURES QTY PRICK Nrr Sink 9.00 rw M+� """' Lavatory 9.00 Owner Tub or Tub/Shower Comb. 9.00 on... Shower Only 9.00 Water Closet - 9.00 Nw jW err w rr..a Dishwasher 9.00 Garbage Disposal 9.00 Occupant ,r," WaW" Machine 9.00 Flow Drain 9.00 cowswe Water Hester 9.00 Laundry Room Tray 9.00 '... Urinal 9.00 U Other Fixtures (Specify) 9.00 9.00 Contractor Z 9.00 a„rmtrr / ar 9.00 Sewer 1st 100' 30.00 rw ftv+ M. ant a..Ta Sewer•ea. Addfl. 100' 25.00 Water Service 1st 100' 30.00 1 I hereby ack"Iedge that I have read this application, that the Water Service ea. Addit. 200' 25.00 information given is conect, that 1 am the owner or authorized agent of the owner, that plans submitted are in compliance with State laws, that Stone 3 Rain Drain 1st 100' 30.00 1 am registered with the Construction Contractor's Board, that the Stone b Rain Drain Addlt. 100' 25.00 number given Is cortnct. (If exempt from State registration, posse Mobilo Horns Space 2.8.00 give reason below.) Back Flow Prevention Device or Anti-Pollution Device 9.00 sem• .....r.�r « Any Trap or Waste Not Connected to a Fwture 9.00 Describe work new 0 additwn alteration repair Catch Basin 9.00 to be done residential Q non-residential Q Insp, of Exist Plumbing 40.00fir Speciely Requested inspections _ 40.00/hr Existing use of building or property Rain Drain, single family dwelling 30.00 Residential backflow prevention devices 15.00 Proposed use of building or property --- *(Except residential backflow, prevention dwfceis) NOTICE "Minimum Fee $25.00 SUBTOTAL PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5%SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY '(IME AFTER VXRK IS COMMENCED. PLAN REVIEW 25% OF SUBTOTAL TOTAL 32 �- Special Conditions Date issued __by Accumulative Sewer Tally Address: _ This FI-M#: Fixture Value Previous Previous Credits Capped Fixtures FixturesNew totNew al I # Value Capped off value added # added #s total Count off #s count value val 1�0 Baptistry/Font 4 �. Bath - Tub/Shower 4 _ Jacuz/Whpl 4 Cuspidor/Water Asp 1 _ - w Dishwasher Corrrmer 4 _ Dourest 2 Drinking Fountain 1 4 Floor Drain 2 inch 2 3 inch 5 4 inch 6 Garbage Disposal 16 Dom Ito 3/4 HP) Comm Ito 5 HP) 32 Ind lover 5 FIP) 48 Oil Sep (Gas Sta) 6 Shower Gang 1 Stall 2 f( Sink - Bar 2. ' Bradley 5 Commercial 3 Service 3 Washer, Clothes 6 Water Ext 6 Water Closet 6 Urinal 6 TOTALS Total fixture values: divided by 16 _ , �� _. EDU HISTORY PLM# ECRU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# F-DU# SWR# PLM# EDU# SWR# I� L•.. .,,�..,. CASE HISTORY FOR CASE NO.: PLM95 0287 SAGRI, BASKET 15350 9W SEQUOIA PKWY Unit: 100 0{/22/99 Action Deeaription Req/ 9chd/ End/ Action Notes Diep By Update UPd code fent Done Don" Date By -------- `---" -----`-- P117C007 Application received / / / / 09/28/95 PA99 JSD 10/05/95 JD PLMco10 Plan check by / / / / 10/05/95 PASS HON 10/05/95 JD 'PLtIc050 (F) Ready to issue / / / / 10/05/95 PASS HON 10/05/95 JD PIMC060 (F) Issue permit. / / / / 10/19/95 PASS BON 1.0/19/95 B PIMC725 Top-out Tnep / / / / 30/24/95 PASS TI.P 10/25/95 TLP PIMC799 Final Inspection / / / / 11/01/1- PASS TLP 11/01/95 TLP PLMCeoo case Finaled / / / / 10/31/95 PASS TLP 11/01/95 TLP t �i ,,, • Commef Teal Building Perrnit ADR11cation City of Tigard ( , F IPss'rs 13125 SW Hall Blvd. Tigard, OR 97223 g � (503) 6394171 / Jobslte Address: 1 � �� .S .>ecL�,r,4, Office Use anly Tenant: -)rj(A,e611-1 5 kL � Sults# /D t^ __ � ,, �// � I • Planck/Rec # Valuation: P - Permit # l5 ��S' NJ Owner: (J`�'��E �S �t — Map & TL (00 Address ---- Approvals Re uq ired -- Planning Phone Engineering Other I Contractor: C (.;' Y rYe5s t'I1 r-f S Address. "Type of const: Occupancy class: � Phone: Z Sprinklered? Yes No Contractor's License # _ (attach Jcopy of current Oregon license) Sq. ft. of project: Contact name & phone: L C'A, Z 3 3. 7 Story,(1st, nd, etc.) Proposed use: ArchitecUEngineer: Previous use: ko i't t Address. Note Plumbing & mechanical plans must be submitted at time of building permit application. f Phone: I ,JOB DESCRIPTION: ,e 1, ' r2 t h� �0 i� P, f z all i i Applicsn ature & Phone number Received b C� C Y Date Received: L.w__ -" � .: -^� y...p,.pr-°. 7p°•i`. ... ,.... ,;•are .nur y 4� �wryy i... f� i ,�y..�y,t x hi Permit 0 Account [description Amount Amt. Pd. Bal.'0ue Bldg. Permit (BUILD) Plumb. Permit (PLUMB) f Mech. Permit (IMECH) I State Tax (TAX) �'1 rte' �• '` ! I Bldg: Plumb: Mech: I Plan Check (PLANCK) Bldg: Plumb: Mech: Sewer Connection (SWUSA) � � 4? Sewer Inspection (SWINSP) Parks Dev Charge (PKSOC) Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) _ Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-O) Water Quality (WQUAI_) Water Quantity (WQUANT) _ Fire Life Safety (FLS) _ Erosion Cntrl Permit (ERPRMT) Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) TOTALS: L 62 Jd.. I; - - z. Q 3 ; Q �i ti. Y O N ►� << „ U-N plarU V CJ � � Q ^ µµ� � vo� � � I M s ---4- _ Y i' T0'd 9E390 WFiTZ:6 5i '8T d3S SS32[dAJ 13NStiH l3JtiH:01 1J31IHa2IH 7-f1NOS 113NH:WON-1 __._. ....,....... 11111x1 ' w , s � 1 CASE HISTORY FOR CASE NO.: BUP95-0416 BAQBI., "SKET 15]50 SW SBQUoIA PKWY Unit: lUO 04/22/99 � Disp By Update U Action De9ariptiao �9/ sold/ F.nd/ Act i011 NOtea y Code Mat DM* Uone Date —— BUPCO07 Appliestion received / / / / 09/28/95 PR24D JD il/ol/95 TLP PRM) BON 10/05/95 B BUPc0o8 Permit. created / / 10/04/95 BUPCOIS Plans routed to Plans Rxaminer / / / / 10/05/95 PRM) PON 10/05/95 B BUPCO24 Plans Approved/Routed to DBTO / / / / 10/18/95 APPS 10/1JRF 6/95 SON BUPC090 (F) Ready to issue 10/16/95 PASS BON 10/1!/95 9 ) Rum OO (F) Inoue permit / / 10/19/95 P1.38 BON 10/19/95 B BUPC460 Devsl review sand met / / / / 04/02/96 P1,33 JDA 04/02/96 JDA RUPC740 Framing Insp 10/20/95 PASS TLP 10/20/95 TLP nUPC760 Oyp Board cusp / / 10/20/95 PASS TLP 10/20/95 TIB RUPC762 cusp Ceiing Insp / / / / 10/27/95 PASS TP 3O/30/95 TLP BUPC793 sprinkler Rough-In / / / / 10/27/95 PASS TLP 10/30/95 TLP RUPC794 sprinkler Final 10/19/95 / / 01/11/95 PASS TLP 11/01/95 TLP BUPC799 Final Inspection / / / / 10/31/95 PASS TLP 11/01/95 TLP BUPC799 Final Inspection 11/03/95 / / / / PASS MTP 11/07/95 MJR BIIPC950 (F) Issue Cert. of Occupancy / / / / 10/31/95 JF 04/02/96 IF iaUPC960 Came Finaled / / / / 10/31/95 PASS TLP ll/Ol%9S TLP - 1 i 1 „..... nrnaaa+*gar»-,+rmrire!Mwc�u�tri+lktW�( ^tfn� ""�4�WAA��fAk'�!d'4!�+i1Aci1;�d1M�RM�lYM1PWMi', r CITE' OF TIGA►RD October 7, 1995 OREGON i Mike Morse and Tony Viola Bagel Basket FAX: 598-7966 RE: PLM95-0287, SWR95-0418 and PLM95-0088, SWR95-0209 i , Mike, I would like to first apologize for not being able to return your telephone call Friday afternoon. I was assigned counter duty and did not retrieve your voicemail until after 5PM. I agreed with your voicemail message and looked into this matter further. It appears our �. plumbing inspector double charged you for your floor sinks. Floor sinks routinely are assessed as "floor drains". Since the diameter of the drain is not known, we always � assume the drain is a two inch variety as this has the least impact on the customer. Please find attached three accumulative sewer tally work sheets for 15350 SW Sequoia Parkway. I first recalculated the sewer assessment for PI-M95-0088. While the sewer assessment was reduced nine fixture unite Niue to our miscalculation, the EDU count still resulted in you heing assessed three EDUs. The good news is that when I recalculated the sewer assessment for PLM95.0287, you did not suffer an additional EDU fee. I would like to apologize for the inconvenience this has caused you and also thank you for keeping us on our toes. I certainly appreciate helping you two out and want to thank you bath for your professional demeanor over what must have been a very unpleasant situation. -. If you have any questions or if I can be of any further assistance, please feel free to telephone me at 639-4171. 1 hope this comes as good news to you Monday morning! Sincerely, 1 / James S. Duckett i i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 — - . 7 4 .��w ":�� :�� -. �'. ,r - � .,y � +� ■1. n.a pr + rw^.+1 i r+.M'P��,wn -� V • CITY OF TIGARD October 5, 1995 OREGON Tony Viola Bagel Basket FAX- 598-7966 j RE- PLM95-0287, SWR95-0418 1 Tony, Please find enclosed a copy of the accumulative sewer tally work sheet for the building located at 15350 SW Sequoia Parkway. As indicated on the work sheet, the accumulative sewer tally total prior to your plumbing fixture addition was set at 279 fixture units. With the addition of your sink, the accumulative sewer tally total is set at 282 fixture units. Using the mathematical formula to determine Equivalent Dwelling Units (EDU)s, this plumbing permit will result in an additional EDU being assessed at the rate of $2200. I Please be aware we can provide copies of each sewer permit associated with this building should the need arise. It is my understanding this particular building's accumulative sewer tally was justified with PacTrust's records a few weeks ago; there is a possibility, however, that our records may be inaccurate and we are always willing to present them for your evaluation. If you have any questions, or if I can be of any further assistance, please feel free to telephone me at 639-4171, Sincerely, James S. Duckett Development Services Technician i i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 -- 'ri$¢4°P.&'eRUr- ., ..1A!a `.::..'... ., :.. —c „ C..., i'n^•i._. .r'.-..•- ''.i;'a tmn.,.�i''t�W�'4faW5�lA'��j ' ' r Accumulative Sewer Tally 7 502`d1 is PLM# Address: Fixture Value !'reviou.s Previous Credits Copped Fixtures Fixtures New New # Value Capped off value added # added total #6 total Count off #s count value _ values Baptistry/Font 4 • Bath - Tub/Shower 4 Jacuz/Whpl 4 Cuspidor/Water Asp 1 _ ---- iDishwasher - Commer 4Z- Domest 2 15 Drinking Fountain 1 �> _ T Floor Drain 2 inch 2 I rich 5 4 inch 6 Garbage Disposal 16 Dom (to 3/4 HPI Comm (to 5 HPI 32 Ind (over 5 HPI 46 Oil Sep (Gas Stal 6 Shower Gang 1 Stall 2 Sink - Bar 2 Zo `-I L) _ Bradley 5 Z Commeicial 3 10 Q1-) > I J Service 3 _ Washer, Clothes 6 Water Ext 6 Water Closet 6 IU`f I U(nal 6 ' II TOTALS Total fixture values: 2`4Z divided by 16 = 11. b EDU HISTORY PI.M# L- EDU# ISWR# �L+L PLM#' j tj EDU# ► [ SWA# '15 3147— PLM# EDU# i SWR 02v� L � EDU# SWR# `jam PLM# "'b -Doc)4 EDU# SWR# �j� -Ql�y7j_ PLM# - 2I Z_ EDU# II SWR# PLM# — -C'V tj-jEDU# Iq SWR# e-75—ULl l PLM#q4-p(S-S EDU# )I SWR# qy'C Z 7D n'y i' pop 91•. ] cA56 HISTORY FDR CADS NO.: SWR95-0410 BAOBL BAgKM' - 151,,0 gW SEQUOIA PKWY Unit: 100 04/22/96 DLap Ay tlpdat4/ llpd A tii+n Descriptia0 Req/ 8chd/ Endi Acticm Not-on _ Date BY code e4ot Dme Done 09/26/99 PASS JSD 10/05/99 JD &IfRA007 Application received / / / / pAgH BON 10/OS/9S JD awpAo10 Plan check by / / 10/09/95 FWRA070 Ready to ieeue / / / / 10/05/95 PASS AON 10/05/95 JD RWRA7IU cane Finaled / / / / 10/16/95 PA.^.3 dD 10/16/95 5 I i.l.. 1e. i _ Pr i PIK F CITY OF TIGARD CEOCCF YUPNE;Y ANCY Or OCr COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : DLIV,95. 01:35 13195 SW HaH Blvd.Tlgerd,Oregon 97223•B1gg (503)639-4171 DATE I1')GaUED: 09/.25/95 PARCEL : 261 12DA- 00400 'ITE ADDR[ Li. . . : l aa:ilfl bW :jLUUOIA PKWY #100 SUBDIVISION. . . . a Z ON I NG e I fi, BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . . CLASS OF WORK. :ALT TYPE OF" USE. . . a COM OCCUPANCY GRP. 13 -1 NR OCCUPANCY LOAD: 62 T E:NANT NAME-. . . :BAGEL 9A!:3KE'T Remarks : TI for bergel deli and kitchen IOwner: __..__.---•-.--•---._..._.___.._.. ._._..._.__.__ _ _._ ._.._ PAULL DArI',ET IV, INC. 5335 6W MEADOWS RD, *365 LAKE CIc;WE:GCI OR 97035 1 Phone Ma 6P4--1333 II Lontrac.tura CYPRE'ia VENTURE=S, ING. 5335 SW ME=ADOWS RD. , 0365 LAKE OSWF;GO OR 47035 I Rhone #1 624. 1333 Reg 0. . -. 77075 1 Occupancy of the mbove refererrr..eci building is hereby _yiven, And certifies. the compliance with the State Of Oregon Specialty lodes for the group, occupAnnvy, use under which the referenced permit was issupci. i _.___. _. __. _ ____�_._._ __._.._ _ _--_•-_._._. _.__............ .._ ____..._.._._---•--._... SUILD1 0 INSPECTOR BUILDING OFFICIAL POS? IN CONSPICUOUS Pl...ACf_ 1 +I 1 , „ ai..�l,,Nia ms's, .. ' . .�• ,�' . ,.. .. - ,,..,�. v..�� , - WASfiINOT N GO.UNT�r De artmeof�Td Use & Transportation RESTRICTED ElectricalJnt'th tAvenue, #350-12 ELECTRICAL ENERGY 155 NoFirst Aveenue, 11350-12 H(503) 4.4 ro, Oregon 97124 APPLICATION Irf/ormat(o (S03)640-3470 Fax: (503)69312 PRINTPLEASE Please completee Permit No. `G_ t..k!_ 11,,5- 003C 1. Location of Inst l/ tion Date �Z5�C1L Address-6556t 7`J --Lm - City___j__ - _ ,-.ip Cede _.�7�a a. Type of work: ' Map No. Tax Lot RESIDENTIAL Restricted Energy Fee $40.00 (` Thomas Map Book: Page �� Section �� (for all systems) I Check type of work Involved: Directions D;c ' Audio and Stereo Systems' P CommercialResidential r l Burglar Alarm LJG Telephone Systems' Tenant Name � Garage Door Opener' (if commercial) Fire Alarm S Heating,Ventilation and Air Conditioning Systems* 2. Contractor application: Vacuum Systems' - Other Electrical Contractor-, -- --- - - Address Q� Y COMMERCIAL Fee for each system $40.00 City ___ _ State Zip 97a 1 - (see OAR 91a-260-280) Date __.lob Number - - Check type of work Involved: Property Owner Contractor's License No. Contractor's Board Reg. No. Boiler Controls Clock Systems Phone NO. Data Telecommunications Installations 3. Owner application: Fire Alarm Installation - HVAC Instrumentation Print Owner's Name Phone No. Intercom and Paging System Landscape Irrigation Control" Address - Medical _ Nurse Calls City State Zip T O r Landscape Lighting' This permit Is issued under OAR 918-320-370. The applicsnt agrees rotective Signaling to make only restricted energy Instsllaflone(too volt amps nr less) Other under this permit and to do the following: -- ----- 1. Only use electrical licensed patrons to do Installations where required. (Certain residential and other transactions are exempt Number of Systems from licensing. These have ssi.rltks("). All others need licens- ing.) 2. Call for an Inspection when ail the Installations under this permit *No licenses are required Licenses aro required for ell other installations. are ready for Inspection. 3. Purchase separate permits for all installations that are not ready 5. Fees for Inspection when the inspector to out to Inspect under this — l permit. Enter fees $ 4. Assume responsibility for assuming that all corrections required by the inspector ars done,and //,, 5. Assume responsibility for calling for a final Inspection when all of 5% Surcharge (.05 X total above) $ U the corrections ars completed. The person signing this permit must ba he applicant or s person Trust Account `� $ � authorize Ind the appli ret. 1 Signature —__ .._I L A Total $ Authority if other than applicant __ This permit becomes null and void It the work authorized by the i! permit le not commenced within 180 days from elate of Issuance cc /� For inspections call of such permit or If the work authorized is suspended or abandoned -3561 or 693-4��15 at any time after work Is commenced for a period of 18o drys. V�� Electrical Permits are non-refundable and non-transferable. E24-hour recorder, one working day In advance of need aL2n-lla " uGwAp�a11�r2b1LifNdl��i�I�NAti t . y � r r- ';a page No. 1 CASE HISTORY POR CASX NO. BLR95-0030 ADT 15350 ON SYQUOIA PKWY Unit: 100 04/22/99 Action Decwription Req/ Schd/ Jbd/ Action Noted Diep By Update Upd " Code fact Dane Done Date By -------- -------- ---------- ---------- ---- -------- --- Y R LRCOO) Application Received / / / / 06/23/95 RECD SUR 12/21/95 TMP RLRCOt)3 Permit Created / / / / 06/23/95 PEND SUR 12/21/95 TMP FLRC500 IFI Inoue permit / / / / 06/23/95 PASS 81B 12/21/95 TMP RLRC700 Ceiling Cover 12/21/95 / / / / 12/21/95 TMP RLRC720 Nall cover 12/21/95 / / / / 12/21/95 TMP R1.RC710 slect`l Service 12/21/95 / / ! / 12/21/95 TMF ..' RLRC799 61ect'1 Final 12/21/95 / / / / 12/21/95 TMP ELRC60o Case finalad / / / / 07/31/95 MJF. 02/06/96 JF I 4 i. is DEPARTMENT OF LAND USE & TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12 ti 155 NORTH FIRST, HILLSBORO, OR 97124 COUNTY, PHONE: 503/640-3470 OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-441 x'�+rmit '06`1b�2n Proofs,-r- M P0049098 6tatus Aki'ktai%i �'ay'f t '.)f Applied U5/11/'9�i Isauad Obi/li/9°; Expir<?s 12/06/99, 06/12/95 05 n:_ COMELEC Forms t Tit 1,? BAGEL BAFKE T 4 (,TK Uescrlption JOB 141 '1. SERVWES/ 32 CIR(CUIT5 E17 13.�qun 017/1. 1 /91; J«l> Addria2 l5nu sw 5EQuoiA PK TI ti._ •_ n L` Owner Name INSPECTION - 7IcsARL f Applicant Namq- COMMERf".IAT, FLECTRICAL COPP �"'-'-----� Fhon,q number. 255-9922 Valuat !�.,r ] n,rpact_�,r .: �mmNnt:r li • :r.fad..... -- REQUEST ERVIR . l 1 Plumbing Mechanical Electrical Strsr_trual. t33neral _ Inc.pected by bate �•�- ��_ InSpoctic:n P4qu4st_4d Wall Cover 0414 E AF LAN IVP D6/12/95 RI 1:IIVR 26-33C E 06/09/95 RI killip 26-33C c'. I 06/0�1/9c, ErN R:7 DNIV2 VFT7 I Bt; i .011w � u DEPARTMENT OF LAND USE 6 TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 4350-12 155 NORTH FIRST, HILLSBORO, OR 97124 COUNTY, PHONE: 503/640-3470 OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415 CPermit It .)67621) Pro jact. tt P0o4g1396 :3tatu.,- APPROVE Priya 1 i ApplJod 05/ 11/9'j I401.110A !)5/11/9ri ExgSr+�..s 1 '1/!1%/q , ('(iME:T.E(:06/t)yE(.' t7�i 1 F'4rmi t Ti t ler BAGEL BASKET 4 OTH U acription 70B 141 2 SF.RVI(!Et3/ ?2 ('IIRt''UITS Begun; 05/ 11/95 1,)b Add ras:= 15?Kro I3W SEQUOIA PK TI � wi►er Nau"a_ INS><E('TION - TIGARD Rg.1an 1, Applicant N1am4 CoMMERGIAL ELEC'TRIl:'Al, (;r)RP I'h.�ne n+amber 255-9622 VaItimt Lon C Approvrd___..-__. ` -tur :nuw%ntg u * 1N•..t�e`� J -PEC VR AJLT�. L REQUE-531' ERR(3" Electrical , -- f lectrical t r u t r u a 1 Inspected r.-•y Date Inspection Requ*rted Well cover 0413 5 F1 06/U9/9r. k ,KII'!K 26-33C F' s til CITY OF T I GARD �C R!,,I TEJ T#L. . . . F 9 RSUP()3 b i COMMUNITY DEVELOPMENT DEPARTMENT DATC ISSUED: 05/31/95 13195 SW Hall Blvd.Tigard,Oregon 97223.5199 (503)639-41111 rAFtGC'l_t �a11G'.DA-IIIQ14�c� tTE ADORE t4'4. :;.,,.w ..` SW SEOUp1A PKWY #5. 100 1JODIVISION. . . . : 70NING: I PL,Or:' . . . . . . . . LOT. . . . . . . . . . . . . . REISSUE FLOOR AREAS'----»• CX!'C•RirR WALL. CCINSTRUCTIC. "ASS OF WORD. 3 ALT F I r3`;T. . . • : _rr � B f N PROTECT . F e W� PE" ("Ir LIGE. . . :Ct7M arCflhlQ. . . -'Pr- or CONST. t 3.. 1 HR THIRD. . . . : '3 f N. Go W: 'CUPANCY Cnr. :A3 "'n'TGIt_ -- '-, �k� f 1;C)OF' 'RE RU.T? UPANCY LOAD 3 62 BASEMENT. ii s; f AREA SCF''. RATEr • r! s H7. s ft ;f OCCU SEP. PnTEL. tN ME`ZZ : : REDO SETDF1CR, .__ .. _.. ..,......_ . .. 7.N Rc'�u1Rcr•�-.��...•�__.__.._.._....... _ - __. wGR ,..00D. . . . , 50 Wr, r 1_CF`T4 ft RGI IT: Ft FIR 57TA :v SMOK DrT. . s 41EL.LING UNITS: F"RNTi ft REARt ft FIR ALRM:Y 14NDICP ACC:Y p.Tii r IMP SURr`ACE_3 F,no CE)r�r:Y r�'WRK 1 D1'. OLUE. t : 15011100► matr k,s . TI fr,t ±7ayttl del i ars+i WiUJiPT1 E`Et Th.C. a: vl�E, �.�mu�cr�t Ly date >^ �,r: .S SM M�'hbow.' RMT 550, 00 0 05/31/95 PLCI' 't ;}ia ;4 JAr 415 1....il9K, - !Mf' 135 Wr'r,.) Ort '37k°7 rtpr- s U.2.'a. ,-:0 JAF' 0`1/ e/9 rangy #o Ec'�+- 1333 3FC T 2 '7. 90 S eni3 i/�3S — Ti'r'r ttL`I': . nc4 '.-1 00 PRCltrN(ITE vz, tit 'PREE.5 VENTURES, INT. 1 H. . a 77075 _ - - RE.CIUIRED INSPECTIONr -.__...__._.._. ,s persit is iss,.ed tibtect to the 1 Fuiat:anc c:antained in the F1'amin►a .lnsp _. .. and Municipal Code, State rf 1.e, Specialty C,des and all other trisulat: i ori InaA .rolicable laws, All work will be ;lone in accordance with Gyp Dt ar•d Iiisp proved plans. This pere:t will expire if walk is not atarted SusR Ce i 1 ng Insri thin 191 days of issuance, o% if wark :r a«soended for ro)•a F'i rya! Ine,F,Pc-t i 0+1 an 181 days. ral� ,,Lee tut F Call fu)- ":moo 417 C Commercial wilding Permit Application - - City of Tigard 13125 SW Haff Blvd. o�ypgs V10? Tigard, OR 97223 ------ (503) 639-4171 15 . S hl. �r,�tl�lr� �Kt-J/"j SDP, �� -000 Jobsite Address• �' � Tenant: ala(,F L r S�F`C suit a>2 CX-1OfficeUae On O Valuation: r7 U i C>U C PlancklRec # i C,� Permit Owner. N,�-- ISY-67r U7, (I-Ic Map & Tt. # .l I Address: � ��' S.YV. #36S + Approvals Required t-Ao--- u5wet-10Or c--r7v3S Planning Phone: Engineering 9 i g�� Other-� Contractor: Address: S3�� S. I k. .�a►�utiJ> QG�. 5 n 11 , r, Type of const: Occupancy class: Nq) Phone: lSL'� G�4 -I V�3 O Sprinklered7 Ye No Contractor's License *_ U-770-75 0*1 �1 (attach copy ofcurrentOregon Ikense) Sq. ft. of project: Contact name & phone: pv'� �F�'I� SS Story Ost, 2nd, etc.) _ Proposed use: L Architect/Engineer- ' �� /v `t ilf��- N - Address: Previous use: C L ( c JA�'T(�', , �¢ �.�✓. LI�.�TcUI'�l �� Note: Plumbing & mechanical plans PCx,TtAN'►, Or R72 !l U must be submitted at time of Phone: S � 2�' SZ L building permit application. f JOB DESCRIPTION: N� �S�iL�G�i� �� y �� ANN W�Jtffk Applicant Signature & Phone number nn Received by: \� o i V Date Received: AI _ r .. l•.. ,..,'r..,.r ........ f'..... .rRY`F•,.-......_—. .. .M.i.s..�..n .:w•.•wa.rr YlYVr..ii�4rrlrr4r...., I Permit# Account Description Amount Amt.Pd. Bal. out ,Bldg. Perot (BUILD) Plumb. Permit (PLUMB) • Mech. Permit (MECH) L State Tax (TAX) C t • Bldg: ci�_� i Plumb: Mech: -710 Plan Check (PLANCK) s Bldg: _ Plumb: Mech: .< (�60 �� Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Storm Drainage Chg (SDSOC) _ C- Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) Op Commercial TIF (TIF.-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) _ Office TIF (TIF-0) f Water Quality (WQUAL) M `Nater Quantity (WQUANT) n Fire Life Safety (FLS) `-S V0 Z2 ` Erosion Cntrl Permit (ERPRMT) _ Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) a- qR TOTALS. Wr1 AdIL Page No. 1 CAJF HISTORY FOR CASE NO.: SUP95-0135 BAGEL, SASr RT TV, INC, 15lso SW SEQUOIA PKWY Unit: 100 04/22/96 ' Action Descriptio, Rei/ Sclul! End! Acti:xt Notes Disp By Update Upd Date By Code Sant Urrne Uwe 0 Huaco2o Plan check by 0!/01/95 / / / / PAS9 DS 11/27/95 JDA SUPC040 Check for prel. restriet. 06/01/95 / / 05/01/95 PASS JDA 11/27/95 JDA BUPC090 (F) Ready to issue / / 05/30/95 JSO 05/30/95 JD HON 01/31/95 H BUPC100 (P) issue permit / / / / 05/31/95 SUPC490 Devel review Gond. met / / 11/77/95 PASS JDA 11/27/95 JDA RUPC740 Framing Inep / / 06/09/95 PASS TLP 06/09/95 TLP BUPC760 GYP Hoard tnap adjacent and mud t• corridor area PART TLP 06/16/15 TLP / / / / 06/14/95 P 6UPC762 -ivap Ceilnq Inep / / / ! 07/05/95 PASS TLP 07/06/95 TI,P EFA MJR 07/31/9', MJR SUPC796 Misc. Inspection 07/31/95 ' SUPc790 Misc. Inspection / / / 07/05/95 SCCA MJR 10/03/95 MJR BUPC799 Final Inspection / / % / 07/14/45 handicap signs to be place PART TLP 07/14/91 TLP RUPC95o (P) Issue Cert.. of Occupancy / / / / 09/35/95 Jr 01/12/96 JF I plipc96o Cane Finaled / / / / 09/25/95 PASS TLP 09/26/°5 TLP 1� 1 i 1 ., : i..,Q.•N +N^y+'Y+'+Iw•M't•aew..w ♦Ml.v•.n. V' .rte♦..+..A+* �► -�, MN �! , FF 4 i. :;EWEP CONNECTIO CITY OF TIGARD �.. . . . PERMIT #. . . . . . >, rb,�.'-,._ y....ti� COMMUNITY DEVELOPMENT DEPARTMENT DATC VZUEDs 05/1/ns 13126 SW Hall Blvd.Tlpard,Oregon e7223•e199 (503)e30-1171 � PARCEL: 2103 1 i GnA- 00400 � Tr S3JO 5W Or" I lJ 4 # ,. 100 '."LJE1pIVISION. . . . t ZONING. I—R PI GCK. . . . . . . . . . c LOT. . . . . . . . TENANT NAME. . . . . c BAGEL. BASKET I.; A NO. . . . . . . . . . s rIXTLIRE UNITS. . . x470 ".L AO)S OF WORK. . . :AL.T I)WCL.L I NO UNIT . . : .. r YPE Or- ISE. . . . . s COM NO. OF BUILDINGS. I."•ISTALL TYRO. . . . a>►tiSb1R ItInr_i„., !+LMFOICE. . : s Pf,Inalrka;t TI far batciel deli and kii:c`)1Pn REQ PLMh;;--OQsQfI :.r1 - rt r3f:l_ DASKE-7 Itl, INf'. tvt,e esmo4-'rit. by date r-.nr r) t SW mrnnC)'w-. nn, 411,r OSWEGO OR 97035 170NTRACTOR NOT ON r';:i_t'_ i G(,00. 00 TOTAL _..... .. FEEL)I RCD I N0PECT 1 GNS ppiicatt ay4•ees to .&soli with al; the ruins an' requlatians Newel TrIr,pect. iar4 th.a L%ifisd 3eKage Agency. The permit expires 181 days free the date issued. The total &saint paid Kill be forfeited if the nereit eKpires, The Agency does net guarantee the accuracy of the aide steer laterali. If the sewer is -'et located at the teasaresent - .en, the installer shall prospect 3 feet i. all directions fros diitance given. If not so located, the installer shall ourchase q, a 'Tap and Side Sewer• Pei-ct a.rrd the Itper. !al' 'Iteral. 41 Call for, insclection — 639 4t7li a. �t k CASE HISTURY F'7R CABG 110,: SWP95-0209 BABEL 8.4SKRT IV, INC. 15350 SW SEQUOIA PKWY Unit: 100 • 04/22/91 Action Description Peq/ Schd/ End Action Notes Diep By Update Upd Cc" Sent Daae Done Date By • 13WRA007 Application received / / / / / / 03/26/95 JD SWRA010 Plan check by / / / / 03/26/95 05/26/95 JD SWRA020 Check for prel. restrict. 05/26/95 / / / / 05/26/95 JD SWRA070 Ready to issue / / / / 45/30/95 JSD 05/30/93 JD SWPA090 (F) Issue permit / / / / 03/31/95 BON 05/31/95 B 9WPA720 Case Finaled / / / / 08/16/95 PASS JSD 08/16/94 JD i i 1, 1 RRNNFF; 3ry t COIL Ti ARD . .. .PERI CITY OG 1:''ERMTT tl, . . a MEC9� 01. a COMMUNITY DEVELOPMENT DEPARTMENT DATE 13126 SW Hall Blvd.Tigard,Oregon 97223.6199 (603)639 11711 TE{r�^-�� p T',r�•• r� T s�aRrct.: x.51 i�:r�A-00kib0 -•� 1 E Ar) M-.-1. . _ : r,».�_.. ,,w .-r.."'.001 A Pl W`l� 4 9. 1 0.0 .IDDIVISIUN. . , . : 'Oh'"`•iCi: I--F' f"1_A a OF' W04-1, :ALT ri..00m r'IJRN. . . 1,17E Or USE. . . . ICOM UNIT I4EATERI~. . : VENT FANS. . . s "t"li1'AIdC r CRF . . s(�:' VC"JTr W,10L.. VENT SYSTEMS4 1. "DRIES. . . . . . . . a 2 POI1 ERS/COMPRCESQRS HOODS. . . . . . . c � !r.L TYPE!- 0 HP. . . . a DOW-" . INCT.N 3-15 VIP. . . . $ I CCIMML. I NC I N t X I1.ru— s STU Is- -o I ICS. . . . : REr'R I R UNI-15.Z ,11rZ DAMP—.r a% . s 3st-00 HP. . . , : WOODS TOVES. . s (.Ars PREGSURC. Hp. . . . . CLO DRYr-P IC.,. Or- AIR HANDLING UNITS 0THER UNITS. . I0011; BTU ( 10000 c:-fin- CSA') OUTLET';. s ' �RN )=r 10q'V STU t > 1171�1Q��r1 r:f m -mm� kss TI for bagel Ciel i and kitchen F'C VA"1117T !+v', INC. 4 YF+e rift -Alit 1)y ijt4t:l' .:,,?iii SW MrAriow" RD, 036!5 PRMT t, 46. riot JA 0S/ ;E*/3w �� c C59C•0 C't.x,11,, IV 1 1. 6:7, Tr Z5 t, G i`7S `)S--CC,5')fs4'i 19;E OSWEGO OR 07035 33 JD 05/816/95 95-2659E10 37' ^GTCMC' f;C;,Ui:Tt1rf:l INC. ,17 N. C. COUCi I MTt_A^SD OR 17L232 _ --._.._._.. ._.__...._ __.____......... _._..__. .... .__... 1'11ir' M.; Z33r�'.'�1 �. '1, _.'i•. 'ilI .J !i'YI._. REVIIJ 1 RED I NSPI CTI ONS is peri;: ;s i`r,Ied subject to the regtilaticns contain=.; in the imechariic:al Inf;p gard Municipal Code, State if Ore, specielty Codes and all other F'•i n a 1 Inspection _._.._ .. _.�. plicable laws, All *wh will be done in accordance nitir moved plans, this perleit will expire if work is lot sta+•ted Chin 188 davr• if ins+aricE, ry if warit is sss"rided for aU+•e ian 181 naps. C.P11 fc•v inisppc:tion 631) .417-- . F City of Tigard MECHANICAL PERMIT Planck/Rec. # 13125 sw Hall Blvd. APPLICATION Permit # Tigard, OR 97223 S ts-,rs P36J (503) 639-4171 / vrnpon PA.c-kFt,C etcrikgor-Am c K/irtiag Table;A Mechanical Cods CITY PRICE AMT Job 1) Permit Fee -0- -0- 10.00 Address — �7 2) Supplemental Permit 3.00 �R umace o - 1) incl. ducts&vents 6.00 I urnac T+-- Qyyn S' ��•L,f, NM�T1` 2) incl. ducts&vents %.50 I Floor Fumanc3 r lj ��t✓ L�� 7 ''_7 3) incl. vent 6.00 VP) ' - s�per�3iaFiealei, welt eater xA1C V_L 4) or floor mounted heater 6.00 Vent not incl.n- Occupant `-I-S 1f1 VN 5)5) appliance permit } 3.00 -fir at hganng,r97 g. -- j."yL o5c-4-6 c" or 6) cooling, absorption unit 6.00 —T3oiiwror cwnp,Iwat pump,air conn 7) to 3 HP;absorp unit to 100K BTU 6.00 - Boiler or comp,heat pump,atr co, Contractor 8) 3-15 HP,absorp unit to SOUK Bi`U ! 11.00 J, Boiler comp,heat pump,air cond. LA4,-(D C4� (7-(722 9) 15-30 HP;absorp unit 5-1 mil BTU 15.00 Boiler or comp,heat pump,air cond. 10) 30.50 HP;absorp unit 1-1.75 mil BTU 22.50 i ere y acknowipage Inal I nave read mis application,triat trie Boder or comp, heat pump,air cond. -- ---- information given is correct,that'am the owner or authorized agent 11) >50 HP;absorp unit 1.75 mil BTU 37.50 of the owner,that plans submitted are in compliance with State fir handing unit to - - laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50 1 that the number given is correct. (If exempt from State registration, --7k7r an inp urnE-- Ti - please give reason below.) 13) 10,000 CTM f 7.50 I --- on porr _ 14) evaporate cooler 4,50 I en an co—nn ec e-(T - 15) to a single duct - 3.00 Ventilation system not C Inc 16) included in appliance permit 4.50 Hood servedy 17) morhanical exhaust 4.5C escn wo new 0addition alteriaban repair ,ommercia or m a:-aa - to be done residentia Q non-residential Q 18) type incinerator 30.00 Existing use o -- er t e.,wn s wa,water — building or p•operty 19) heater, solar, (ticthas dryers,etc. 4.50 I Proposed use of 20) Gas piping one to four outlets 2.00 building or property - — _ Type of fuel- oil Q natural as LPG 21) More than 4-per outlet 9 O Q electric Q Minimum Fee$25.00 SUBTOTAL t PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 1?0 DAYS,OR 5%SUP°CHAAGE �? IF CONSTRUCTION OR WORK IS SUSPENDED OR - ABANDONED FOR A.PERIOD OF 180 DAYS AT ANY TIME PLAN Ri:VIEW 25%OF SUBTOTAL AFTER WORK IS COMMENCED. ,,� Special �al Conditions -- - - 1 _ Data issued r by YrMkCNPVT � ' .o,dM.eTew _. .. :.. ','v� '11Y5#NW�PAy '�n'4MIVlMg1t=n:gauT. _ IdP pYv Rage No. 1 CASS HISTORY FOR CASE NO.: t4MC95-0125 4 BAO6t., HAAKRI TV, TNC. 15350 SW 96RUO,TA PKWY Unit! 100 1 01/22/99 R / 9ehd/ Rnd/ l.eticxl Notes Diep By update Acticn Deacriptim Dote by Code Seat Dore Dons ,;. ----- ------------------------ ----- -------- -.. ------ ------- -__. s lO2CCOIo Plan check by 0!/O1/f5 APPS. JHP 05/75/95 JAF / / / / 05/15/95 BON 05/25/95 C:'R � 102CCOSO IP) Ready to ireve J9D OS/26/95 JD MRCC060 !F) Ieeue permit / / / / 05/26/95 f / MUCC705 tbaa Line Inep 06/]9/95 PASS TLP 06/79/!5 TLP 05/09/95 / / 09/25/95 PASS TLP 09/26/95 TLP MRCC710 Mechanical Tnep PASS 'rt,P 09/26/95 TLP M8CC799 Rinal Inapeation 09/25/95 Wcceoo case Finaled 09/25/95 PASS TLP 09/26/95 TLP r. TT F I I R i r. ) i i 'F r �s4 1`1 ..1 „ �,., ^,,.,r.,.,,,» ”s-„•'"t*''^"'n'Arf"tr�^""'"�'p�, 'Y"�"r..y �.. ,�,,,*,..,•-•pr �► +ryl rw r. ,.� *y..y�.,rri,y DEPARTMENT OF LAND USE 6 TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION . 155 NORTH FIRST,HILLSBORO,OR 97174 COUNTY, INSPECTION REOUESTS: 503/640-3581/693-4415 OREGON nxxxn Page i, ,of 1 Date 05/12/9,• 'Time 10 , 34 Permit 'Type : Commer-cial Electrical Perm-. , Permit # ObOb7620 r Permit Status APPHUVEU Applied 0'x/11/95 bites Addreos I 15J:t0 SW 1)EQU()IA PK '1'1 Issued Oh/11/95 Vermit 'Tithe BAIlEL bA�:,KET 4 Completed Permit Uescr , JO8 141 r. SEHVIc_'Eb/:1Z C1RC't. ITS To Expire 11/07/95 � Project 'Title I HAIJEL bA.:,KF.1' 4 Project st : P0049898 Project Uescr. I JULY 141 l bERVICES/32 CIRCU11-b EROSION Pat.cel Number 'ZS 1'1'1 - Land Use District valuation l) Legal. De act: , owner 1Nbt'EC"l ION - TJ.t1ARL: Construction OTH Applicant Name COMMERCIAL ELEC I-RICAL C.URP Classification goo Api. licant Acta,. , . 10928 Nr. K1LL1Nl,SWUH'TH Occupancy P(JR1'LAND, UH 9'/220 Validated by PH Applicant Phone, Zbb-98ZZ inspector Area : Fee description Units Fee/Unit Ext fee Data --------------------------------------- 6ervire/F'eederi200 amps or less Z 60 . 00 120 , 00 t:ac•ti braric•h W/ Feeder L Enter # 1 32 b . UU 160 . 00 Subtotal Electrical. Fees : ZHO, 00 ;hate Surcharge. of .,'k 14 , 00 Total Electrical Fees : 294 , 00 +:** Fees hequired * A * *** Fees Collected & Credits *** ------------- Method Check # Heceipt• No . Date Payment CK 8962 Ub/11/95 294 , 00 Fees : Z94 . 00 A-ijustments ., , Oil 'Total Credito : 00 Total. Fees : 294 . 00 'Total Payments : Z94 . 00 balatic•c- Due: 00 NOTICE: This permit becomes null and void If the work or comttructlon for which it Is Issued Is not commenced within 180 days. Once construction has started, the permit becomos null and void 11 conetructlon Is Interrupted for a period of 180 days. I certify that the Information presented by the applicant and his agent or agents In support of this permit In true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance upon false and misleading Information may Invalidate this permit All provisions of applicable laws and ordinances governing the construction and use of this building or structure will be compiled with whether or not spnelfled on the plane or noted on the plans correction sheets. I acknowledge that the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of the stnicture or bt-ilding permitted depends upon my calling for Inspections at various times during tho process of construction and the building Inspection staff verifying compliants with the various codes. Use or occupancy of the building or structure permitted prior to approval by the Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satlsfled and approval Is given by the Building Official. I further acknowledge that a lien may be pasted on the title of the property upon which the permit Is Issued specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements. APPLICANT'S SIGNATURE s. 'r IT77 F WASHINGTON COUNTY ELECTRICAL PERMIT Department of Land Use 8r Transportation Electrical Inspection Section 155 North First Hillsboro, Oreg nvenue97124 350-12 APPLICATION • Information: (503)640.3470 Fax: (503) 693-4412 Permit , ; • Number L-r`,—"/- ��r -- DarePlej *lete all ' a 4. Complete Fee Schedule below 1. Location of Installation Number of Inspections per permit allowed Address 15 3$C) IiGL I1' Service included: Items Cost(ea.) Sum _ Buildingg A. Residential-per unit City,��_� Suite fJo. d toxo aq.ft.Ol lase $1 to.00 _ a Tenant Nalo G� c � _ Each additional 500 sq.ft fl commerc I\�aTi r or portion thereof $25.00 Limited Energy — $25,00 1 Map No._ __ _Tax Lot Each Manufd Home or Modular Dwelling Service or Feeder -- $68.00 —_.,____. 2 Thomas Map Book: Page:_ � Section: Directions___ B. Services or Feeders Installation,alterations or relocntioa� 0Cly 200 amps or less $60.00 _.1_`=_ 2 Commercial Residential❑ 201 amps to 400 amps $80,00 2 f 1401 amps to 600 amps $120.00 _ 2 2a. Contractor Installation oniv 601 amps to 1000 amps $180.00 2 COI`iMET�IAL Over 1000 amps or volts $340M _. 2 Electrical Contractor C�1L CORP. Reconnect only � $50.00 2 Address 10928 NX._-RiMinswwo—r_ ► - City_�,0LLL=Lj __ State_O_ ZIPS 220 C. Temporary Services or Feeders Date_ 5/9/95 Job Number 1 41 _ !nstallalion,alteration or relocation Property Owner_ __ 200 amps or less $50.00 _- 2 Contractor's License No. _ - 201 amps to 400 amps $75.00 - _ 2 Contractor's Board Reg. No— _— 401 amps to 600 amps $to0.00 _ 2 Over 600 amps to 1000 volts sae'B'above 4, �JIO Signature of Supr. Eler,'n _ �c_ D. Branch Circuits t License No. Phone No 255 q822 _ New,alteration or extension per panel a) The fee for branch circuits with 2b. For owner Installations: purchase of service or I er fee. o0 Each branch circuit z- $5.00 �+j XX 2 not mer s F7eme one o. --- b) The fee for branch circuits without purchase of service or feeder fee. c7llTr rasa - -- First branch circuit $35.00 _ 2 Each add'nl branch circuit $5.00 2 E. Miscellaneous (Service or Feeder not included) Each pump or irrigation circle $40.00 2 The installation is being made on property / own Each sign or outline lighting $40.00 2 which is not intended far sale, lease or rent. Signal circuit(s)or a limited — - energy panel,alteration Owner's Signature or extension $40.00 2 F. Each additional inspection over the allowable In any of the above t 3. Plan Review section (if required) Per inspection $35.00 Per hour $55.00 please check appropriate hem and enter fee In section 5B. In Plant $55.00 _4 or more residential units in one structure _Service and feeder, 800 amps or more 5, Fees oa _System over 500 volts nominal A. Enter total of above fees $ _ � __Classified area or structure containing special 5% Surcharge (05 X total fees) $ occupancy as described in N.E.C. Chapter 5 Subtotal $ cc B. Enter 25% of line A for Submit 2 sets of pians with application where any of the Plan Review if required (Section 3) $ above apply. Not required for temporary construction Subtotal $ ! services. - ---- (I Trust Account $ _ Balance Due $ 1 For Inspections call i This permit becomes null and void If the work authorfrod by the permit is not oomm*n(*d l 640-3561 or 693-4415 within 100 days from date of Issuance of such permit or If the work sulhoritod Is t 24-hour recorder, one working day in advance of need eulMrl"Permit dod or ate non-refundable any and`on-tranate able.work In �d Iw a�`�of leo days visa i LL Y WASH.CNTY,OR.l_I.IT%6Lf)G 1 503 f-01 3993 P.01 DEPARTMENT Of LAND USIE i TRANSPORTATION i�V�SHINGT(�N LAND DEVELOPMENT SERVICES DNISION 0350-12 ISS NOR'iti FIRST, HILLSBORO, OR 07124 . COUNTY, PHONE: 150;V640-•' 470 OREGON INSPECTION REQUESTS (24 hours): 503/640.3591 or 693.1 � ,rs�it fi* 01067620 Project #: P0049896 Status APPROVED Palo 1 of 2 O1/11/95 issued 0.5/11/9%. . Expir6s_ : 12/09/95 07/13/95 05 : 02 COKSLEC rli t• Tit10 BAGEL BASKKT 4 OTH Arription _ JOB 141 2 SERVICES/32 CIRCUITS. Doqun: 05/11/95 � iy Addresi: 1 15350 SW SEQUOIA PK TI k�= Nene "`'•'. • INSPEC`TION .- TIGARD Region D (cant Nt11i4 COMMERCIAL" ELECTRICAL CORP -.- ;L ho 'e number 255-9822 Valuati6hs 0 . Approved..______.__ Appraval9: Af PR n.ipector Comments: Re jectecl !•_ VJR-AE:6ULTS REOLIEST EPROD I techanical : :1 e c t r i c a l 'tr-7trual .nepected by: ______ Date : Inspection Requ4sted: * final Electrical 0499 E Ap LAN 1VR 07/13/95 RI R11VR 26-33C C~ E "7Y'I�F}*�y,� ,...,,, .«.a..,.w>,«..,,�.-.....n,.w..,.., ..•w.,r+nwun:«v.wv+.,nwr�tiE .. �9Ip�{ � , aie1i""""" -.:iSC{"8N11k91.'N1il�prk�'AMII�Q w j4-' . rt i a{p r Y . k Fax Transmittal Memo mn � I '04I ago" *DOW Som- "'"""'' rr.r ""°"°"' (P 3°1- y 1 4- e�.1 ow 4�. TRAFFIC 1MP'ACT FEE InstaNmevA Pal~Appkx on end Disclosure Stsoment i In the Metter of the Traffic Impact Fee for OACELI� T IV INC Tax Mop ZS 11,E Lot Numbers)AMpq-_ Building PON -01up�g1,?t Io SRe Addrew �ae0 &I6PARKW►YJjQ&W.Oft 9722,1 Subdihslon_NIA —_--- # Cass FIN• TIF IAM Use District I-P_ To Be BOW To Address:_N&WIN ` 4..U1lSE U5INEQQ,-QR__ � To the City of Tigard: `I In accodance with dfs pftWM$on of Oregon Revised Sistine 223203 and WestIar"Mo Crum 0rdin0X* ill i' No.319 witch rnNles to the 0.mositkxi of a traffic hnped fee for OwRnen ang of rnaW collector roads and arteriole of Wee"ton County. INre HEREBY MAKE APPLICATION AND AGREE, JOINTLY AND rs }� SEVERALLY,to pay myfour"ITIC It1"c fee.as has been determined by Waehiro n Cour"Or*WICa No. 370 in _20_ seftwannual rwtelknenta of the amatnt ilnenoed Ooged+er with on~of one year's .vyr Interest thereon at a nab of A.Z1 snnum Penxntage rate on rite unpaid arTount owed. The Nen date is Or Arlt day of the month following the doh the applka" Is signed. The first payment s dire six ( r ' rvm is dwnmAer and at six(6)moroUr Intervals thsrwW for a p lod of_ years. Each Instatlrnant { Payment*01 Include ptindprrl and interest If 11we neglect or rouse to pay any part of the installments provKW herein, including inhrsst,within ane (il yew grow the cams shall have become due and payer, Ion the wht>b amount of to unpaki assessment shell become due and hayyable M once and shall be CAeeCfed M the mane provided by law including k"xlosum on tit eboMs4esrxibed feel property. The haft nnpect M,annual percentage rate of koter@st(AUN and finance charges which IAve agree to pay ane es follows: HIGHWAY TRANSIT I �. 1) Amount of Traf6e impost Fee 2. �—... 7) Amount FltCed 3 ,643 00 2 Sf>0.00 3) Fqunt gon*AMlual Principal Psymsrts S 202.15 125.4Q-._-._ 4) Interest on Saft>oe at Rate of 6.77 % 1111W understand that the amount owed, as sWtad above,shall be a Iden on to above-descrih*d sublect Property pursuant to Washington Coutdy Ordirranxw No. 379 Section 6(D)arch ORS 223.230. DATED this_. _ dxy of, j". Sgnsture of Property Owner(l) S0"rturo of Property Orwaags) Lesser STATE OF OREGON ) Nama(Plesse Print) �'� hen �_N1�r'S� :1 ) Address: l3"1SS >E Lc u�5{+arw cdo�~HTi'K) County of Washington ) me thea �_day of t9 M:WK.MAM66 MANNE PANTELY ' �y Y PUBLIC"ORE01 NotaryPublic for O ISSIONN0 0397»1 � -3 t,`98 \ r C My Commission Expres: �1" r '1 , b f r CITY OF TIGARD 'COMMUNITY DEVELOPMENT DEPARTMENT 13126 SW Hall Blvd.Tigard,Oregon 97223.5199 (603)1139.4171 "LUMPING PERMIT PEPMTT #. . . . . . . . PLMr15 00911,, 1,39•- 4171 DATE ISrC;UrD: 05/05/9 ITE ADDRESS. . . : 15350 GW E1 UUOIA PI`.WY �UBDIVISIOIN. . . . s ZONING: 1—P LOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . . ____.__._.._..,._....----__._.__.....__ ..nqS OF WORK,. . e()1_T G A P B A G C D 10P05AL.-. . : M0£I i_L-' 14011E �"Pncr . Ir)r: OF USE. . . . 3COM WASHING MACH. . . . . . . s BACKFLOW PRE"VNTRS. . : 1 ... .;UPANCY ^RF='. . ;B3 : FLOOR DRAINO. . . . . . . . TRAPS. . . . . . . . . . . . . . . 'TORIES. . . . : 1 WnTCR HEATERS. . . . . . s CATCH BASINS. . . . . . . a IX'rUREa-.-- 1.AUN►^,RY TRAYS. . . . . . : ar RAIN INKS. . . . . . . . . . :2 URINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . . s +VPTORICu. , . . . : OTHER r- I XTURf-W'S. . . . . : T US/ HOWERG. . . . : SEWER LINE (ft) . . . . : 10.10 IATCP CLOSETS. . .C: WATC R 1_I NE {f t ) . . . ., . 1EHWASHEIRS. . . . .. 1 RAIN DRAIN (ft ) . . . . QMAc, ks : T01ANT 1t1Pn0VrMC:NT :Nners PEES --.. .__-.._..._. ACir is CORPORATE Cr'NTr_'R tyt'e 0111 .,: t; by dat(2 517"70 SW SF_DUOIA PARKWAY, #100 PRt1T $ 14? 00 SW OF5/05/95 PL.C1; $ 4iG. 75 SW 05/05/95 _,iRD OR 97"-'23 5'r-F-T 1, 711 0W 055,'95 hone #s 1 antra4ctor: — ""JrJE M'ORt..AN r'I_(.1HP T'dG & AI'L T ANCEU'l-, .35 SW PACIFIC HWY NAL50 ISEE - GE'OnGL h10RLAN PLUMOI!Nf., T CARD OR 97�2, 3 .. . ..... .__.. _.... .._._... ._------__.._......__.__.._ _.. . .. one #: c:14 G81) # 1 )1. 1 TOTAL #. . s 0'''734 _.._ .__-•_-.._ REOLI T RED INSPECTIONS - •-.__. ._._. .s pereit is issled subject to the t•egulatians contained in the Rough—ir1 Irtsp gard Municipal Code, State of Ori. Specialty Codes and all other Top-•out Inch -auplicabie lads. All Nark will be done in accordance with RP/Doc.,kflow rl -ev aprored pians. This pereit will expire if work is not started 'r inal inspec:t inn .thin 180 days of issaa7ci, .r if world is suspended for sore `tan 180 days. 6 a used Call fere inspection - 639. 4175 of Tigard Fl UM81NG PERMIT APPLICATION Planck/Rec. # x1125 SW Hail Blvd. h Permit # )11 � igard, OR 97223 'A (503) 639-4171 MINIMUM $25.00 PERMIT FEE + ST, SURCHARGE rr..row.yw� New Single Family ResiderwAs Only PnGI RL G��'i'�'r,fa'TF Gfr�4 ...... W 0 1 BATH HOUSE s140.00 0 2 BATH HOUSE $195.00 Job (r�"s Sr(A)L)A PPCI Ks'✓Pti C 3 BATH HOUSE$223.00 I � Address arse. a � Fee Inckrdes ad plumbing fixtures in tM dwelling and the first 100 feet (" r q�✓,z of water service. sanitary sewer and storm sewar. See lees below. FIXTURES CITY PRICE AMT IN 6. Sink _5 9.00 us"*ANN ¢►S6 t G; lavatory �- _ 9.00 - Owner ub or Tub/Shower Cory*, 9.00 aro.. no Shrjww Only 9.00 Water Closet`�� 9.00 j Ift"IN"am rboom" Dishwasher 9.00 r"rN/'2:L gT Garbage Disposal 9.00 Occupant ,.s AdWw„ r„�„ Er 4 Washing Marine 9.00 �TAXy<;I-1UP• t333 Floor Drain 9.00 error. err Water Heater 9.00 Laurxfry Room Tray 9.00 Unnal 9.00 Other Fixtures (Speer) 9.00 Contractor �MOM 77�I�1�� o r--(= 0'" JIIS 9.00 M, c s�., �� 9.00 < arias t fit- 4 �Ck .- 9.00 C PU4 q*-\6 oc /-7.744 Sewer 1st 100 30.00 "- VAN"'s""""Na nr rw r,"r Sewer-ea. Addtt 100' 25.00 3,{`7U iZA1,r (? l ^ it ��-71 Water Service 1st 100; 30.00 1 I hereby acknowledge that I have read this application, that the Water Service an. AddIL 200' 35.00 information given is cornett, that I am the owner or authorized agent of ---- _ the owner, that plena submitted are in compliance with State laws, that Stone &Ram Drain let 100' 30.00 I am registered with the Construction Conhactor's Board, that the Storm 6 Rain Drain Addle 100' 25.00 number given is correct. (If exempt from State registration, please _ give reason below.) Mobile Home Space 25.00 Beck Flow Prevention Device or Anti-Pollution Device �^ 9.00 Any Trap or Waste Not _ Connected to a Fxture_ 9.00 Describe worts new addition aReratlon ( repair Catch Basin 9,00 to be done residential Q non-residential Q Insp. of Exist. Plumbing 40.00/hr Specialty Requested Inspections 40.00Rv Existing use o/ building or property Rain Drain, single family dwelling 30.00 1 _- _ Residential backflow prevention devices 15.00 Proposed use of "r building or prccerty ---- .(Except residential backflow proventfon devfces) do NOTICE *Minimum Fee $25.00 SUBTOTAL / PERMITS BECCME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT CCMMENCED WITHIN 180 DAYS,OR IF 5%SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS � �! COMMENCED. PLAN REVIEW 25% OF SUBTOTAL --- ---� TOTAL Special Conditions _ Date issued fit ,. __._..._. ...._-.r-...........-,. .. .._......:......�..«.n�:sa:nu.'.:wanuw-V•aanw-a.......«...-........_•-n.�wu,......yw„wqf„ '� 1 t Page No. 1 CAB$ HIATORY FOR CARR NO.: P6M95-0066 PACIFIC CORPORATR CRNT6a • 15750 BM BROIICIA PFNY Unit: 10(' 04/22/99 Active Description P'-q/ Schd/ Rnd/ Acrion Notes Disp By Update Upd • CO" sent Dane Dane Data By PIMA711 Nater Service Insp / / / / 06/09/95 PASS TLP 06/09/95 TLP P[MS710 Neter Line Innp / / / / 06/0619S PASS TLP 06/09/95 TLP PIMC060 (F) Iss11e permit / / / / 05/05/95 PASS SXN 05/05/95 SN PIAC120 Plumbing Underel / / / / 05/15/95 PASS TLP OS/16/95 TLP PLMC715 Rough in Insp OS/OS/96 / / Os/09/95 PASS TLP 06,109/95 TLP PLMC750 RP/6ackfl�w Prevemter o5/OS/9S / / 07/12/95 requir rp devise for pop dispenner FAIL •L, 07/13/95 MRS PLMC799 Final Inspection / / / / 07/12/95 reg.rp devise for pop dispenser PART Ms 07/13/99 MRs devise% need to be tested PL14C799 Final Inspection / / / / 09/21/95 need plumb contractor to go thru job FAIL MS 09/26/95 TLP PIMC6o0 Came Finaled / / ! ; n9/25.95 PASS TLP 09/26/95 TLP i i a h t w. -------TWO- CITY OF TIGARD May 2, 1995 OREGON tiVV Brett Schulz Architect 2646 NW over-ton Street Portland OR 97210 Project : Bagel Basket Plancheck #4-37C 15350 SW Sequoia Parkway, Suite 100 Subject : Building Plan Review I (1991 UBC with Oregon Amendments) The plans ft)r this project were reviewed for conformity with applicable codes. Please submit; the following items for completion of the plan review process at your earliest convenience : A 'o 1 . Submit two copies aof d site on the propea site (vicinity) pian for location of this building d 2 . Submit a typical wall detail for review. Provide diagonal bracing for walls exceeding 10 fent in length to the structure above . t 3 . Submit a typical installation detail of the suspended ceiling for seismic zone 3 . 0 4 . Submit complete details for the accessible rest rooms . 5 . Provide a seating diagram for review. 6 . Submit complete kitchen equipment and load plans for review. 170 7. Indicate construction type (3-1hr) and occupancy (A-3) on IF the plans . • 8 . The men' s and women' s rest rooms shall comply with the following: a. The rest room - shall have a smooth hard nonabsorbent surface which extends upward onto the wall at least 5 inches (Section 53.0 (c) 1) . 13125 SW 44011 Blvd„ Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 - N „ y 4 b. Walls within 2 feet of the front and sides of urinals and water closets shall have a smooth, hard rionabsorbent surface of Portland cement, concrete, ceramic tile or another smooth, hard • nonabsorbent surface to a height- of 4 feet, An.d except for structural elements, the materials used in such walls shall be of a type which is not adversely affected by • moisture (Section 510 (2) . 9. Handles, pulls, latches, locks and other operating devices on doors, windows, cabinets, plumbing fixtures and storage facilities shall have lever or other shape permitting operation by wrist or arm pressure and not requiring tight grasping, pinching or twisting to operate. The force required to activate such equipment shall be not greater than 5 pounds force (Section 3109 (c) l) . ' 10. The highest operable part of environmental and other controls, dispensers, receptacles and other operable equipment shall be within at least: one of the reach ranges specified in Section 3109 (b) , and not less than 36 inches above the floor. Electrical and communications systems receptacles on walls shall be mounted a minimum of 15 inches high above the floor (Section 3109 (c) 2) . .A 11 . If provided, food service tray slides shall abe mounted not more than 34 inches high above the floor (Section 3109 (u) 2B) . 12 , Counter tops and siAs shall be mounted at a maximum ` height of 34 inches above the floor (Section 3108 (d) 3) , in areas accessible to customers . 13 . Provide at least 5 percent, but not fewer than one accessible seat and table in the dining area. Accessible fixed or built-in seating or tables shall comply with Section 3109 (r) . In eating and drinking establishments, such seating or tables shall be distributed throughout the facility (Section 3108 (d) 5) . 14 . The door to the corridor system shall be a one-hour, fire rated assembly, self-closing with smoke gaskets (Section 3309 (c) ) . 15 . When two or exits are required from a room or area, exit signs shall be installed at the required exits from the room or area and where otherwise necessary to clearly indicate the direction of egress (Section 3314 (a) ) . r t 16 . Exit doors from Group A Occupancies having an occupant P, load of. 50 or more shall not be provided with a latch or lock unless it is panic hard(Section 3317 (d) ) . A key- locking device may be used in place of the panic hardware on the main exit only, provided there is a readily visible, durable sign adjacent to the doorway stating, r "THIS DOOR MUST REMAIN UNLOCKED DURING BUSINESS HOURS" (Section 3317 (d) exception) . f 17 . Submit a copy of Washington County' s Health Department report for review. 18 . Tempered glazing is required in fixed or operable panels adjacent to a door where the nearest exposed edge of the glazing is within a 24-inch arc of either verticle edge of the door in a closed position and where the bottom exposed edge of the glazing is less than 60 inches above the walking surface (Section 5406 (4) 1, 6) . Also, any glazing in doors to be tempered. Please make these corrections on the appropriate pages of the drawings and resubmit three copies of each page to the City of Tigard for review. 'Phis plan review does not include electrical or plumbing plan reviews. Electrical concerns can be directed to Washington County 1 at 640-3470 and plumbing concerns to Mike Sheehan at the City of Tigard at 639-4171 ext . 312 . If you ha any questions or concerns, please do not hesitate to call . Sincer y, - Da`.id S t, P.E Building Official m:prmsys\document\bup95—ol.35\pc#437c.doc y, w CITY OF TIGARD i, f' May 2, 1995 OREGON i Brett Schulz Architect ` 2646 NW Overton Street Portland OR 97210 Project : Bagel Basket Plancheck #4-37C 15350 Sw Sequoia Parkway, Suite 100 Subject : Building Plan Review (1991 UBC with Oregon Amendments) i j The plans for this project were reviewed for conformity with applicable codes . Please submit the following items for completion i of the plan .review process at your earliest convenience : i 1 . Submit two copies of a site (vicinity) plan for location j of th?s building and site on the property. 2 . Submittypical wall detail for review. Provide diagonal bracing for walls exceeding 10 feet in length to the structure above . r 3 . Submit a typical installation detail of the suspended ceiling for seismic zone 3 . l 4 . Submit complete details for the accessible rest rooms . S . Provide a seating diagram for review. 6 . Submit complete kitchen equipment and load plans for s review. 7 . Indicate construction type (3-1hr) and occupancy (A-3) on the plans . 8 . The men' s and women' s rest rooms shall comply with the a following: a. The rest rooms shall have a smooth hard nonabsorbent surface which extends upward onto the wall at least 5 inches (Section 510 (c) l) . f 13125 SW Nall Bbd., Tigard, OR 97223 (503) 639-4.171 TDD (503) 684-2772 1 �,. Walls within 2 feet of the front and sides of _ urinals and water closets shall have a smooth, hard nonabsorbent surface of Portland cement, I concrete, ceramic tile or another smooth, hard nonabsorbent surface to a height of 4 feet, gnd except for structural elements, the materials used in such walls shall be of a type which is not adversely affected by moisture (Section 510 (2) . • 9 . Handles, pulls, .latches, locks and other operating / devices on doors, windows, cabinets, plumbing fixtures and storage facilities shall have jjever or other shape permitting operation by wrist or arm pressure and not requiring tight grasping, pinching or twisting to operate . The force required to activate such equipment Shall be not greater than 5 pounds force (Section 3109 (c) 1) . i 10 . The highest operable part of environmental and other controls, dispensers, receptacles and other operable equipment shall be within at least one of the reach ranges specified in Section 3109 (b) , and not less than 36 inches above the floor. Electrical and communications systems receptacles on walls shall be mounted a minimum / of 15 inches high above the floor (Section 3109 (c) 2) . If provided, food service tray slides shall abe mounted not more than 34 inches high above the floor (Section 3109 (u) 2B) . J12 . Counter tops and sinks shall be mounted at a maximum I height of 34 inches above the floor (Section 3108 (d) 3) , in areas accessible to customers . 13 . Provide at .least 5 percent, but not fewer than one accessible seat and table in the dining area . Accessible fixed or built-in seating or tables shall comply with Section 3109 (r) . In eating and drinking establishments, such seating or tables shall be distributed throughout the facility (Section 31081d) 5) . i 14 . The door to the corridor system shall be a one-hour fire rated assembly, self-closing with smoke gaskets (Section 3309 (c) ) . eit O15 . When two or exits are required from a room or area, exit V signs shall be installed at the required exits from the room or ,area and where ot`.rwise necessary to clearly indicate the direction of �grea;s (Section 3314 (a) ) . ilk I Exit doors from Group A Occupancies having an occupant load of 50 or more shall not be provided with a latch or lock unless it is panic hard(Section 3317 (d) ) . A key- locking device may be used in place of the panic hardware on the main exit only, provided there is a readily visible, durable sign adjacent to the doorway statin,T, "THIS DOOR MUST REMAIN UNLOCKED DURING BUSINESS HOURS" (Section 3317 (d) exception) . i 7 . Submit a copy of Washington County' s Health Department j report for review. Tempered glazing is required in fixed or operable panels adjacent to a door where the nearest exposed edge of the glazing is within. a 24-inch arc of either verticle edge of the door in a closed position and where the bottom exposed edge of the glazing is less than 60 inches above the walking surface (Section 5406 (d) 1, 6) Also, any glazing in doors to be tempered. Please make these corrections on the appropriate pages of the drawings and resubmit three copies of each page to the City of Tigard for review. This plan review does not include electrica or plumbing plan reviews . Electrical concerns can be&irecte Washington County at 640-3470 and plumbing concerns to Mike Sheehan at the City of Tigard at 639-4171. ext . 312 . T you have any questions or concerns, please do not hesitate to call . i Sincerely, David SC 0,t; P`.E Building Official baa ,xt I v i , y r!. m•pcmrys\document\bup95—o1.35\pC#437c.doc y i I � i rwv WNW WASHINGTON COUNTY OREGON PR I Iy • ys April 7, 1995 • • Mike Morse 5335 SW Meadows Road, #365 r Lake Oswego, Oregon 97035 RE: The Bagel Basket 15350 SW Sequoia Parkway, #100 Portland, OR Dear Mr. . Morse : The Washington County Department of Health and Human Services has obtained the plans for the proposed Bagel Basket to be located at 15350 SW Sequoia Parkway in Portland, Oregon. i It is our understanding that community water and community sewer will be utilized at this structure. The following is understood to be planned with necessary changes and conditions for approval noted: 1) The plans show a three compartment sink unit to wash, rinse and sanitize utensils in. Each compartment of the I 1 three compartment sink unit must be large enough to totally submerse your largest multi-use utensil . The plans show one drainboard on each side of the three compartment sink. One drainboard must be designated for soiled utensils and the other for clean utensils . An accurate test kit is required to test sanitizer concentration in the third compartment of: your sink. 2) The plans do not indicate which sink will be designated for food preparation. Any sink used for food preparation (washing, thawing, etc. ) must drain indirectly to a floor sink. If existing sinks used for other purposes will be used for food preparation, they must have compatible use . Neither handwashing sinks or mop sinks may be used for food preparation. The third compartment of the three compartment sink may be utilized for food preparation if i it wastes indirectly to a floor sink. 3) The plans show a utility mop sink. Please supply a mop hanging device so mops and similar floor cleaning equipment can be cleaned and hung between uses . I ' I Department of Health& Human Services 155 North First Avenue Hillsboro, Oregon 97124 � WIC Nutrition Plan: (503) 640-3555 Administration & Planning: (503) 693-4402 TDD: (503) 648 8601 ?i�kyt Health Services: (503) 648-8881 FAX: Clinic 693-4522/Administration 6934490 Environmental Health: (503) 648-8722 i r r� tr5' • r Page two 4) There must be a handsink designated in each of the food or drink preparation and food or drink dispensing areas. Handsinks are shown in the service and kitchen areas and conveniently located to all areas. 5) All handwashing sinks including the restroom handsinks must: be equipped with dispensed soap and dispensed r sanitary towels or approved hand drying devices . Common (cloth) towels cannot be used to dry hands . If disposable towels are used, easily cleanable waste receptacles must be conveniently located near the handwashing facilities. The handwashing sinks must be equipped with hot and cold tempered water. If self-closing, slow-closing, or metered faucets will be used, they must- be designed to provide a flow of water for at least 15 seconds without the need to reactivate the faucet . 6) The restaurant plans indicate seating for approximately forty-nine. Two restrooms are shown with a total of two toilets and two handsinks . This number of fixtures is adequate for indicated seating. 7) The restrooms must meet all. the requirements as described in the 1987 Oregon Food Sanitation Rules for design, construction and operation. Be aware that restroom doors must self-close and that there must be at least one covered waste receptacle in the women' s restroom. 8) The food preparation sink, icemaker, soft drink machine, espresso machine, kettle and any other piece of equipment utilized to hold food or ice in that is equipped with a drain must waste indirectly. Where air gaps are required, the distance between the bottom of the waste pipe and the top of the floor sink or drain must be at least one inch or two waste pipe diameters whichever is greater. i 9) Any refrigeration unit which does not come equipped with an evaporator pan for its liquid wastes must have its liquid wastes drain indirectly to a floor drain or floor sink. 10) Floor sinks and floor drains must be located eo they are accessible for cleaning and maintenance. 11) All floor, wall and ceiling surfaces must be smooth, durable, sealed and easily cleanable and in a light color. 12) Where paint is used on walls and ceilings, high gloss is recommended. It is also highly recommended that walls behind cooking and dishwashing equipment and the mop sink be covered with durable, washable backsplash. Y i • Page three 13) If acoustical ceiling tile are utilized and they become soiled and can not be cleaned then replacement will be �llu required. A washable ceiling finish is recommended for preparation areas. 14) Self-service salad/condiment areas must have a smooth, nonabsorbent floor covering such as vinyl, tile or. the • equivalent extending 30 inches on each sine to which the public has access. 15) The plans submitted show a self-service beverage area. Please be aware that beverage drinking containers can p t be refilled on dispensing units that require the container to come into contact with the beverage machine . The lip of used beverage containers should never come in contract with a beverage dispensing unit or an ice dispensing machine. 16) Base coving at least four inches in height will be needed on all wall./floor junctures that require wet mopping. 17) Any gaps in floors, walls, or ceiling around plumbing or electrical work must be filled in to prevent rodent and insect access and entrance. 18) Exposed utility lines and pipes can not be installed horizontally on the floor. 19) All lamps over or within food storage, food preparation, and food display facilities and facilities where utensils wpm and equipment are cleaned and stored shall be shielded, r coated or otherwise shatter resistant . 20) Each refrigeration unit not equipped with an accurate built--in thermometer, must have a spirit stemmed thermometer located on the top shelf or door. 21) A metal probe thermometer accurate to ±2 degrees F must be provided to assure attainment and maintenance of proper internal cooking, holding or refrigeration temperature of potentially hazardous foods . 22) Each hot holding facility storing potentially hazardous food shall be provided with a numerically scaled indicating thermometer accurate to ±3 degrees F, located to measure the air temperature in the coolest- part (if the facility and located to be easily readable. Recording thermometers, accurate to ±3 degrees F, may be used in lieu of indicating thermometers. 23) Where it is not practical to install thermometers on equipment such as bain-maries, steam tables, steam kettles, heat lamps, cal-rod units, or insulated food transport carriers, then the product thermometer must be available and used to check internal food temperatures . 24) If perishable foods will be reheated, a method to reheat this food to 165 F within 30 minutes must be provided. Steam tables, Bain maries and crock pots are not allowed f }� for rapid reheating or cooking of foods. fi 4 ?�Iu �`1 �� azo ,E� {�.• Kl,*t.I; r:'P u�c , , �� ,� �� Y i" , s I' Page four 25) If perishable food will be cooled then a method to rapidly cool this food must be provided. Commercial air cooled refrigerators or ice baths are recommended for cooling foods. When foods are cooled in the refrigerator, they must be cooled in shallow containers no more than four inches deep with food no more than three inches in depth in the container. Perishable food must be cooled from 140°F to 45°F or less in no more than four hours. 26) All equipment must be installed so as to be moveable or properly sealed to facilitate proper cleaning. 27) Storage shelves must be smooth, impervious, and easily cleanable. Unfinished wood is not acceptable. 28) To minimize manual contact of foods, please provide and utilize handled scoops and other appropriate utensils . 29) Food may not be stored under exposed or unprotected sewer lines or water. lines, except where automatic fire protection sprinkler heads may be required by law. 30) All storage of food, food containers, and single service utenoils must be on shelves at least six inches above the floor except where storage is on wheeled platforms or four inch high sealed bases . Metal pressurized containers need not be elevated. 3l ) All floor mounted equipment, unless readily movable, must be sealed to floor, installed on a concrete or otherwise smooth base at least four inches high, or elevated on legs to provide at least a six inch clearance between the floor and equipment . 32) Be aware that all food or food items in the facility which are within customer reach and are not prepackaged, must be protected from customer contamination by a sneeze shield or other approved means . Please see the NSF pamphlet that is enclosed for information on sneeze shield requirements . 33) If food delivery is planned then deliveries must be made in approved company vehicles with approved equipment that will keep products at proper temperatures . 34) Outside storage areas or enclosures must be large enough to store the garbage and refuse containers and must be kept clean. Garbage and refuse containers, dumpsters and compactor systems located outside must_ be stored on or above a hard, nonabsorbent surface such as cement or machine--laid asphalt that is kept clean and maintained in good repair. 35) Your plans show seating for more than 30 patrons and will need to conform with the Oregon Clean. Air Act designating smoking and nonsmoking areas. For your convenience, a copy of this Rule is enclosed. i h� I r I 7*"W 1 Page five 36) The local plumbing authority may require a grease interceptor be installed. If a grease interceptor is required, it must be located and installed so that it is � effective. A maintenance schedule must be developed and followed to prevent grease from going down the sanitary sewer. 37) All plumbing must meet the requirements of the Washington County and the Oregon Uniform Plumbing Cale . 38) This facility and its operation must meet al.l the Oregon Food Sanitation Rules and Statutes . 39) All employees must have current Washington County Food Handler' s Cards . For information call 640-3460 . 40) A preopening inspection must be conducted by aur Department prior to license approval and operation. Please contact me at 648-8722 at least one week prior to operation to schedule this inspection. 41) The license fee of $275 . 00 and license application must be submitted to this office prior to the preopening inspection. if any future changes are necessary, it will be required that those changes be approved by this Department . Very truly yours, � DEPARTMENT HEALTH AND HTIMAN SERVICES or' Toby Har3-is, R.S . Environmental Health and Sanitation TH:aat Enc: C: l� {I I , i A cumulative Sewer Tally Address: S ` gid `"`' This PLM#, Fixture Value Previous Previous Credits Capped Fixtures Fixtures New New # value Capped off value added # added total Ns total Count off qs count value values_ Baptistry/Font 4 — - Bath - Tub/Shower 4 — Jacuz/Whpl 4 Cuspidor/Water Asp 1 _ Dishwasher Commer 4 --- Domest 2 Drinking Fountain 1 J Floor Drain 2 inch 2 3 inch 5 4 inch 6 _ Garbage Disposal 16 l Dom Ito 3/4 HP) Comm Ito 5 HP) 32 Ind lover 5 HP) 48 -- oil Sep (Gas Sts) 6 Shower - Gang 1 _ Stall 2 Sink - Bar 2 Bradley 5 Commercial 3 ( } Service 3 — Washer, Clothes 6 Water Ext 6 Water Closet 6 �A _ /c Urinal 6 �� TOTALS Total Total fixture values: divided by 16 = ' EDU ; %u r HISTORY PLMX !`:-C i'EDU# 1 SWRA PLMIr' 7EDUk SWFI# �= C1- c C, PPI-M# -�� EDUA� /� SWR / � L PLMar EDU# 2 SW'RJt PLIVIrr I1 O�� EDUp �'v SWRk c' c'w,3 PLM#r �?y'`i I`' EDU# �� SWRA 9c; C,3r// PLM �zt�9 r'EDUA' SWR# 1777.7- PLM# c'rsT�EDU# SWRA I .i' I Accumulative Sewer Tally l� Address: i; .•� ,. ,, This PLM#: � 3 ,t' FiMtUre Value Previous Previous Credits Capped Fixturea Fixtures New New # Value Capped off value added # added total #s total Count off #s count value valuer, Baptistry/Font 4 _ Bath - Tub/Shower 4 • Jacuz/Whpl 4 Cuspidor/Water Asp 1 Dishwasher - Commer 4 C' Domest 2 Drinking Fountain I Floor Drain 2 inch 2 z 3 inch 5 ( ' 4 inch 6 Garbage Disposal 16 Dom Ito 3/4 HP) Comm Ito 5 IAP) 32 Ind lover 5 HP) 48 Oil Sep (Gas Sta) 6 - Shower Gang 1 Stall 2 Sink Bar 2 - Bredlev 5 Commercial 3 Service 3 Washer, Clothes 6 Water Ext 6 Water Closet — 6 Urinal 6 TOTALS Total fixture values: ��^�" divided by 16 t EDU HISTORY PLM# t'�' ''�EDU# SWR# f7 PLM# ` ` �` EDU# / SWR# v PLM#— l c,'-e a"* EDU# SWR# c:, G'c l l PLM# / 5 EDU# /' SWR# C PLM# nc EDU# SWR# �c' C_''3v�' PLM# Nt h, EDU# SWR# PLM# �` c ` y'EDU# / C' SWR# r` `, C�c/�` PLM# EDU# SWR#